基于锥形束CT对上颌窦分隔分布的影像学分析

目的：运用InVivo Dental软件对北京第二炮兵总医院口腔科锥形束CT（CBCT）影像学资料进行回顾性分析,研究2012年7月至2013年10月期间就诊于我院口腔科成人人群中上颌窦底壁分隔与年龄,性别以及缺牙情况的关系,以期为上颌窦底提升术提供解剖学依据和手术指导。方法：选取538例研究对象的上颌窦CBCT影像资料,其中上颌后牙区缺失牙与不缺牙组各269例,分别按照性别、年龄分组。将所有数据导入In-VivoDental软件中,通过三维重建,测量记录上颌底壁分隔的发生率,位置,高度,方向及形态学变化,采用SPSS18．0软件包对数据进行统计学分析。结果：538例研究对象中,89例有窦分隔,发生率16．54％;29例出现多个窦分隔（5．39％）,25例双侧同时出现分隔（4．64％）;在测得的1076个上颌窦中,116个出现窦分隔,发生率为10．78％;男性中年不缺牙组的窦分隔出现率最高;原发性分隔出现率远远超出继发性分隔出现率;窦分隔的发生与性别、年龄及牙缺失无关。窦分隔主要出现在上颌窦中部,占51．720／0;平均高度左侧为（6．17±3．35）mm,右侧为（6．50±4．22）mm,平均长度右侧为（10．87±2．96）mm,左侧为（10．05±4．27）mm。结论：北京第二炮兵总医院口腔科2012年7月至2013年10月期间就诊患者成人人群中,16．54％出现窦分隔;上颌窦分隔出现率与缺失牙,不考虑年龄及性别。     

江苏汉族人群上颌窦间隔解剖结构的锥形束CT研究

目的:通过拍摄锥形束CT(CBCT)结合Simplant软件,研究江苏地区汉族人群中上颌窦窦间隔的解剖学变化,为上颌窦底提升术提供解剖学依据和手术指导。方法:选取424例研究对象的上颌窦CBCT影像资料,将获取的Dicom文件数据导入到Simplant软件中,通过三维重建,测量分析上颌窦间隔的发生、位置、高度、方向及形态学变化,采用SPSS17.0软件包对数据进行统计学分析。结果:424例研究对象中,190例有上颌窦间隔,发生率为44.81%;90例出现多个窦间隔(21.23%);87例双侧上颌窦同时出现窦间隔(20.52%);在所测的848个上颌窦中,277个出现窦间隔,发生率为32.67%;窦间隔的发生与性别、年龄及牙缺失无关。窦间隔主要出现在上颌窦中部,占59.94%;平均高度右侧(5.90±3.65)mm,左侧(5.54±2.87)mm;平均长度右侧(8.15±2.40)mm,左侧(7.88±2.73)mm。结论:江苏汉族人群中,44.81%出现上颌窦间隔;CBCT能全面而准确定量分析上颌窦窦间隔的解剖结构,为上颌窦底提升术提供解剖学依据,对手术操作具有指导意义。     

CBCT评估牙源性炎性疾病与上颌窦黏膜增厚相关性的回顾性分析

目的:用CBCT评估上颌窦黏膜增厚与牙源性炎性疾病之间的关系.方法:回顾性分析572例患者的1144侧上颌窦CBCT影像资料,明确上颌窦和牙齿之间的解剖关系并进行分类.测量并记录上颌窦黏膜及其相关牙齿的临床资料.结果:338例患者(59.1％)单侧或双侧上颌窦黏膜增厚.黏膜增厚与年龄、性别和牙齿缺失之间具有相关性(P<...     

北京地区成年汉族人群上颌窦骨分隔及窦底小骨尖/嵴的CBCT影像分析

目的:利用CBCT影像研究上颌窦骨分隔及窦底小骨尖/嵴的数量、位置及发生率,分析CBCT在上颌窦提升手术中的临床应用价值.方法:收集北京地区21-70岁之间、上颌牙列完整的500例汉族人群的CBCT影像资料,分别对其左右侧上颌窦骨分隔数量、方向及对应牙位、窦底小骨尖/嵴数量及对应牙位进行观察记录和统计分析.结果:1.当研究对象为上颌窦数,骨分隔的发生率为21.6％;当研究对象为人数,其发生率是28.8％;骨分隔数量多为一个,占88.4％;分隔方向多为矢状向,占67.6％;骨分隔最好发的位置在上颌第二磨牙(M2)对应的上颌窦底区域,占43.9％,其次在上颌第一磨牙(M1)区.2.以上颌窦数为研究对象,窦底小骨尖/嵴的检出率为36.0％;以人数为研究对象,其检出率为50.2％;窦底小骨尖/嵴的好发部位依次为上颌第二磨牙(M2)、上颌第一磨牙(M1)、上颌第二前磨牙(PM2)、上颌第一前磨牙(PM1)及上颌第三磨牙(M3),占比分别为31.6％、27.0％、23.3％、9.2％及8.8％.小骨尖/嵴的发生率远高于上颌窦骨分隔,在临床中应予以重视.结论:术前通过对CBCT影像资料的观察分析,可以对上颌窦骨分隔及窦底小骨尖/嵴做出准确评估,能够为上颌窦手术的路径及手术方式的选择提供依据.     

北京地区成年汉族人群上颌窦骨分隔及窦底小骨尖/嵴的CBCT影像分析

目的:利用CBCT影像研究上颌窦骨分隔及窦底小骨尖/嵴的数量、位置及发生率,分析CBCT在上颌窦提升手术中的临床应用价值.方法:收集北京地区21-70岁之间、上颌牙列完整的500例汉族人群的CBCT影像资料,分别对其左右侧上颌窦骨分隔数量、方向及对应牙位、窦底小骨尖/嵴数量及对应牙位进行观察记录和统计分析.结果:1.当研究对象为上颌窦数,骨分隔的发生率为21.6％;当研究对象为人数,其发生率是28.8％;骨分隔数量多为一个,占88.4％;分隔方向多为矢状向,占67.6％;骨分隔最好发的位置在上颌第二磨牙(M2)对应的上颌窦底区域,占43.9％,其次在上颌第一磨牙(M1)区.2.以上颌窦数为研究对象,窦底小骨尖/嵴的检出率为36.0％;以人数为研究对象,其检出率为50.2％;窦底小骨尖/嵴的好发部位依次为上颌第二磨牙(M2)、上颌第一磨牙(M1)、上颌第二前磨牙(PM2)、上颌第一前磨牙(PM1)及上颌第三磨牙(M3),占比分别为31.6％、27.0％、23.3％、9.2％及8.8％.小骨尖/嵴的发生率远高于上颌窦骨分隔,在临床中应予以重视.结论:术前通过对CBCT影像资料的观察分析,可以对上颌窦骨分隔及窦底小骨尖/嵴做出准确评估,能够为上颌窦手术的路径及手术方式的选择提供依据.     

北京地区成年汉族人群上颌窦骨分隔及窦底小骨尖/嵴的CBCT影像分析

目的:利用CBCT影像研究上颌窦骨分隔及窦底小骨尖/嵴的数量、位置及发生率,分析CBCT在上颌窦提升手术中的临床应用价值.方法:收集北京地区21-70岁之间、上颌牙列完整的500例汉族人群的CBCT影像资料,分别对其左右侧上颌窦骨分隔数量、方向及对应牙位、窦底小骨尖/嵴数量及对应牙位进行观察记录和统计分析.结果:1.当研究对象为上颌窦数,骨分隔的发生率为21.6％;当研究对象为人数,其发生率是28.8％;骨分隔数量多为一个,占88.4％;分隔方向多为矢状向,占67.6％;骨分隔最好发的位置在上颌第二磨牙(M2)对应的上颌窦底区域,占43.9％,其次在上颌第一磨牙(M1)区.2.以上颌窦数为研究对象,窦底小骨尖/嵴的检出率为36.0％;以人数为研究对象,其检出率为50.2％;窦底小骨尖/嵴的好发部位依次为上颌第二磨牙(M2)、上颌第一磨牙(M1)、上颌第二前磨牙(PM2)、上颌第一前磨牙(PM1)及上颌第三磨牙(M3),占比分别为31.6％、27.0％、23.3％、9.2％及8.8％.小骨尖/嵴的发生率远高于上颌窦骨分隔,在临床中应予以重视.结论:术前通过对CBCT影像资料的观察分析,可以对上颌窦骨分隔及窦底小骨尖/嵴做出准确评估,能够为上颌窦手术的路径及手术方式的选择提供依据.     

CBCT诊断双侧上颌第一前磨牙3根1例

患者,男,14岁．因牙列不齐到我院正畸科要求诊治,为明确诊断进行CBCT（eone- beam computed tomography）检查．CBCT显示：11、12腭侧2枚多生牙。同时水平位图像清晰显示双侧上颌第一前磨牙3根及3根管（图1）．牙根形态分布与上颌第一磨牙相似．由腭侧根、近、远中颊侧根组成．     

青海地区成人上颌窦间隔锥形束CT的研究分析

目的:通过锥形束CT(CBCT)结合测量软件,研究青海地区成人上颌窦间隔的解剖学变化。方法:选取300例成人研究对象的CBCT影像资料,测量分析上颌窦间隔的发生、位置、高度、方向及形态学变化。用SPSS17.0软件对数据进行统计学分析。结果:300例研究对象中,有80例出现上颌窦间隔,发生率为26.7%;窦间隔的发生与性别、年龄及牙缺失无关。窦间隔主要出现在上颌窦中部(41.4%);平均高度右侧(6.60±4.08) mm,左侧(6.81±4.24) mm;平均长度右侧(9.28±2.99) mm,左侧(9.00±3.00) mm;颊腭向多见(85.2%),完全性为主(80.5%)。结论:青海地区成人中有26.7%出现上颌窦间隔,在上颌窦底提升术时应予以重视,采取适当的对策。     

上颌窦提升术中上颌窦解剖生理及病理的 CBCT 探讨

目的:探讨上颌窦生理及病理性CBCT影像表现,为上颌窦提升术解剖定位和操作入路提供参考依据。方法:收集涉及上颌窦的CBCT资料,分析上颌窦解剖特征及病变。结果:1.上颌窦解剖结构位置及其比邻关系复杂;2.影响上颌窦提升术的解剖因素有生理及病理性两种:生理性如上颌窦内的分隔,上颌窦外侧壁的厚度,窦壁上存在的血管影像的粗细,病理性如窦腔内黏膜的增厚,上颌窦内的黏液囊肿,上颌窦内的大量积液等等。结论:CBCT能够准确地显示完整的上颌窦影像,利用CBCT确定解剖定位标志,确定上颌窦提升手术路径和方式,更符合安全、准确、微创的口腔种植理念。     

上颌窦气化及其相关解剖特征的锥形束CT分析

目的 应用锥形束CT(cone beam computed tomography,CBCT)分析上颌窦不同气化分型的发生率及相关解剖特征的差异性.方法 选择2020年1-6月就诊于南昌大学附属口腔医院并拍摄CBCT影像患者200例,对其CBCT图像进行重建分析.依据上颌窦底与上颌后牙的位置关系将上颌窦气化类型分为正常气...     

苏州地区汉族人上颌第一、二恒磨牙牙根变异的锥形束CT观察

目的揭示苏州地区汉族人群上颌第一、二恒磨牙各型牙根变异的发生状况。方法调取苏州口腔医院放射科接受锥形束CT扫描的汉族患者的CT图像资料,患者共257人。观察上颌恒磨牙牙根变异的牙齿发生率、个体发生率及双侧分布状况。率的比较采用卡方检验,左、右侧的相关性采用Spearman等级相关性分析。结果上颌第一恒磨牙融合根的牙齿发生率3.1%(15/484)。上颌第二恒磨牙3根的牙齿发生率为69.7%(285/409),双侧共同发生率为60.3%(117/194),男、女组间以及双侧差异均无统计学意义(P>0.05);牙根变异以2个颊侧根融合最常见(11.7%),其次为融合性单根(10.5%),近颊根与腭根融合的发生率为4.9%。牙根变异在左、右同名牙间具有显著的相关性,相关系数rho=0.607(P<0.01)。结论上颌第一恒磨牙较少发生牙根变异;上颌第二恒磨牙融合根在苏州地区汉族人中具有较高的发生率,掌握其分布特点具有重要的临床意义。     

上颌前磨牙根管变异及其与上颌窦关系的锥形束CT研究

目的:利用锥形束CT研究上颌前磨牙牙根及根管系统解剖形态,为临床提供影像学依据。方法:选取720例成人患者（18~67岁）的锥形束CT扫描图像,按年龄分为5组：18~28岁、29~38岁、39~48岁、49~58岁及>58岁组,分析上颌前磨牙牙根及根管数、根管类型、两根管口间距离、根管弯曲度、根尖到上颌窦底距离、左右同名牙的对称性等及与年龄的关系。采用SPSS21.0软件包对数据进行统计学处理。结果:上颌第一前磨牙多为双根管（89.72%）,根管类型以Ⅳ型最常见（57.78%）。上颌第二前磨牙单根管发生率（53.06%）略高于双根管（46.94%）,根管类型以I型（53.06%）为主。左右同名牙牙根及根管数目多为对称分布。上颌前磨牙单根、双根管检出率随年龄变化而变化,两根管口间距离与根管类型关系密切。上颌第一、第二前磨牙颊舌向弯曲的根管检出率分别为32.53%和21.50%,存在S形复杂弯曲根管。16.69%的上颌第二前磨牙与上颌窦为关系密切型（d≤0.05 mm）。结论:上颌前磨牙牙根及根管解剖结构复杂,左右同名牙呈对称性。根管形态、结构和类型存在增龄性变化,根管弯曲情况复杂,牙根与上颌窦关系密切。     

Prevalence and location of maxillary sinus septa in the Taiwanese population and relationship to the absence of molars

Objectives: Understanding the septum structure of the sinus is necessary for correct implant placement in the maxilla if sinus encroachment is required. The exact mechanism that controls septum development is unclear, although a role for the irregular pneumatization of the sinus floor following tooth loss has been suggested. The aims of this study were to examine the prevalence and location of sinus septa in the Taiwanese population and to determine whether there is a relationship between the presence of septa and the absence of molars. Materials and methods: Using computed tomography (CT) scans of sinuses obtained from 423 subjects (216 women and 207 men, mean age 53.65 years), septum morphology and its correlation with the presence of molars was examined. Results: About 30% of subjects (124/423) had sinus septa, corresponding to 20.45% of all sinus segments detected (173/846). Fifty‐nine patients had multiple septa, giving a prevalence of septa of 22.93%. Septa were located most frequently in the regions of the first and second molars. The prevalence was not related to tooth loss (edentulous, partially edentulous, or dentate maxillary segments). Logistic regression analysis showed that men were significantly more likely to have septa than were women (OR=1.67; P=0.019). Conclusions: In the 423 Taiwanese subjects tested, the prevalence of septum was 29.31% according to the subjects and 22.93% according to the sinus segments. The most frequent location of septa was in the region of the first and secondary molars. No correlation was observed between the presence of septa and the absence of molars.     

A clinical study of the outcomes and complications associated with maxillary sinus augmentation

PURPOSE: The aim of this study was to evaluate the rate of complications in maxillary sinus augmentation surgery and the impact of complications on subsequent implant treatment in a patient population with severe maxillary atrophy scheduled for treatment under general anesthesia. MATERIALS AND METHODS: The study population consisted of 70 patients (124 sinuses) with severe maxillary atrophy who underwent maxillary sinus augmentation. Sixteen patients were scheduled to have a unilateral procedure and 54 patients a bilateral procedure. Sinus augmentation was performed with autogenous bone alone in 93 sinuses; in 31 sinuses, a 1:1 mixture of autogenous bone and corticocancellous pig bone particles was used. Twenty-six of 124 procedures involved both sinus augmentation and autogenous block grafting for the treatment of severely atrophic maxillae. RESULTS: The most common intraoperative complication was the perforation of the sinus membrane, which was observed in 31 sinuses (25%). Seven (5.6%) sinuses in 7 patients exhibited suppuration of the maxillary sinus. Five of the 7 patients with sinus infection were smokers, showing a prevalence of complications significantly greater in smokers compared to nonsmokers. Moreover, the use of an onlay bone graft in conjunction with sinus augmentation appeared to significantly increase the rate of infective complications. Infections were treated by drainage and the administration of systemic antibiotics. Two clinical cases showing persistent signs of infection required an endoscopic inspection of the maxillary sinus. DISCUSSION AND CONCLUSION: In the present study sinus membrane perforation was not shown to be a significant factor in the rate of implant complications. However, the combination of smoking and onlay bone grafting could significantly increase the rate of postoperative infection following sinus grafting.     

Maxillary sinus septa: prevalence, height, location, and morphology. A reformatted computed tomography scan analysis

BACKGROUND: The sinus lift technique may be difficult to perform if an aberrant sinus anatomy is encountered during surgical exposure, such as when a septum is present on the sinus floor. The objective of this study was to determine the prevalence, size, location, and morphology of maxillary sinus septa in the atrophic/edentulous and non-atrophic/dentate maxillary segments. METHODS: The sample population consisted of 100 patients (41 women and 59 men, with a mean age of 50 years, ranging between 19 and 87 years) for whom treatment was being planned for implant-supported restorations. Reformatted computerized tomograms (CT) from 200 sinuses were analyzed using imaging software. RESULTS: The prevalence of one or more septa per sinus was found to be 26.5% (53/200), 31.76% (27/85), and 22.61% (26/115) in the overall study population and the atrophic/edentulous and the non-atrophic/dentate maxillary segments, respectively. In the analysis of the anatomic location of the septa within the sinus, it was revealed that 15 (25.4%) were located in the anterior region, 30 (50.8%) in the middle region, and 14 (23.7%) in the posterior region. The measured heights of the septa varied among the different areas. The mean heights of the septa were 1.63 +/- 2.44, 3.55 +/- 2.58, and 5.46 +/- 3.09 mm in the lateral, middle, and medial areas, respectively. CONCLUSIONS: It can be inferred that there is a wide anatomical variation in the prevalence, size, location, and morphology of maxillary sinus septa, irrespective of the degree of atrophy. Therefore, to prevent the likelihood of complications arising during sinus augmentation procedures, a thorough and extensive understanding of the anatomic structures inherent to the maxillary sinus is indispensable.     

Assessment of Maxillary Sinus Septa Using Cone-Beam Computed Tomography: Etiological Consideration

Background: Septum presence in the maxillary sinus complicates sinus floor elevation surgery, and so it is important that septa are accurately diagnosed on preoperative imaging.
Purpose: Septa were observed regarding their relationship with the bony palate using cone-beam computed tomography (CT).
Materials and Methods: Thirty maxillary sinuses with dentate jaws of 15 dry skulls and a cone-beam CT unit were used. A septum was defined as a pointed bone structure, and an exostosis was defined as a rounded bone structure. The occurrence and locations of maxillary sinus septa and exostoses of more than 2 mm in height were evaluated. Also, angles between the direction of septum and median palatine suture were measured on axial images.
Results: Twelve septa of 11 maxillary sinuses (37%) and nine exostoses of nine maxillary sinuses (30%) were observed. Also, 42% of septa and 67% of exostoses were antero-posteriorly aligned according to the transverse palatine suture. Moreover, the mean septum angle was 57.9 degrees in the anterior maxillary sinus region, and 101.8 degrees in the transverse palatine suture region, and significant differences were noted between them.
Conclusion: Maxillary sinus septa and exostoses could be clarified regarding their relationship with the bony palate using cone-beam CT.     

A study of the septa in the maxillary sinuses and the subantral alveolar processes in 30 patients

The objective of this paper is to study the incidence of septa in the maxillary sinus and measure the height of the underlying alveolar process using panoramic radiography and computerized tomography (CT scans). Thirty patients who were going to be treated with dental implants were submitted to panoramic radiographs and CT scans. Sixty maxillary sinuses were analysed and divided into 2 groups: group 1 (totally edentulous) and group 2 (partially edentulous). The sinuses were divided into 3 regions (anterior, middle, and posterior), the septa were analysed, and the heights of the alveolar processes were calculated in these 3 areas. Of the 30 patients, 36.5% had maxillary sinuses, and 25% of these sinuses had septa, and 11.8% of the panoramic radiographs were false-negatives. In the panoramic radiographs of 10 patients, 3 had bilateral septa, 5 had a septum in only one sinus, and 2 patients had 2 unilateral septa. In the CT scans of 11 patients, 4 patients had a bilateral septa, 5 had a septum in only 1 sinus, and 2 patients had 2 unilateral septa. Therefore, 2 more septa were observed in the CT scans. In the study of the height of the subantral alveolar process, the least amount of difference between both techniques occurred in the middle region of the sinus. The CT scan is more reliable than the panoramic radiograph in diagnosing maxillary septa because of its greater accuracy. In the panoramic radiograph, the middle portion of the alveolar process in the posterior subantral segment was the least distorted of the three portions measured.     

Structural and functional changes of nasal cavity and maxillary sinus in patients with skeletal class III malocclusion 1 year after bimaxillary surgery

Purpose

This study aimed to analyse changes in the nasal cavity and maxillary sinus structure and function in patients with skeletal class III malocclusion 1 year after bimaxillary surgery.

Materials and Methods

In this study, cone-beam computed tomography (CBCT) images of 20 patients (10 men and 10 women; mean age 24.3 ± 3.4 years) with skeletal class III malocclusion who underwent Le Fort I osteotomy and bilateral sagittal split osteotomy were obtained before and 1 year after the surgery. CBCT data were stored opened with element 3D (E3D) to establish a nasal airway model (the paranasal sinus includes only the maxillary sinus). Ansys (ANSYS) software is used for simulation and analysis.

Results

The maxillary sinus and nasal cavity volumes decreased significantly 1 year after the surgery. After surgery, the volume of nasal cavity decreased by 13.5%, and the average volume of maxillary sinus decreased by 7.8%. There was no significant difference in the degree of deviation of the septum and nasal cavity resistance, and air distribution in the maxillary sinus did not change. The nasal cavity wall shear stress change was similar to that before surgery.

Conclusions

The maxillary sinus volume and nasal cavity volume of patients with skeletal class III malocclusion changed significantly after bimaxillary surgery, but there was no significant change in nasal ventilation function 1 year after surgery.     

乌鲁木齐市汉族中学生上颌恒磨牙卡氏尖的调查

目的:了解卡氏尖在汉族人恒牙列中的表达特点和规律。方法:对乌鲁木齐市8所汉族中学生人群(3 819人)进行口腔检查,记录卡氏尖在上颌恒磨牙的表达强度(分为5级)。卡方检验比较不同牙位、不同性别、左右侧卡氏尖的发生率。双侧相关性采用Kendall检验。结果:卡氏尖(3～5级)的牙齿发生率在第一磨牙为14.38%(1 097/7 629牙),第二磨牙为0.47%(36/7 633牙);而其个体发生率分别为17.55%(669/3 812人)和0.60%(23/3 816人)。在上颌第一磨牙,卡氏尖在右侧的发生率要显著高于左侧(P<0.05),男性组的发生率显著高于女性组(P<0.05),双侧共同发生率为63.38%(424/669人),双侧相关系数tau为0.768(P<0.05)。结论:掌握卡氏尖在恒牙列的表达规律具有重要的人类学价值。